Clinical research studyFluoroquinolone prescribing in the United States: 1995 to 2002
Section snippets
Data sources
The NAMCS and NHAMCS are multistage probability surveys administered by the Ambulatory Care Statistics Branch of the National Center for Health Statistics of the Centers for Disease Control and Prevention.25, 26, 27 The NAMCS collects information on patient visits to non–federally funded, community, office-based physician practices throughout the United States. The NHAMCS collects information, in two components, on patient visits to hospital emergency departments and outpatient departments. The
Statistical analysis
We calculated standard errors for all results as recommended by the National Center for Health Statistics using SUDAAN software, which accounts for the complex sampling design of the surveys.29, 30 All statistical tests were based on estimates that had less than 30% relative standard error (i.e., the standard error divided by the estimate expressed as a percentage of the estimate) and were based on 30 cases or more in the sample data.
To assess changes in fluoroquinolone prescribing over time,
Overall antibiotic prescribing
Visits by adults with an antibiotic prescription increased from 75 million (95% confidence interval [CI]: 64 to 80 million) in 1995 to 95 million (95% CI: 80 to 109 million) in 2002. However, as a proportion of all adult ambulatory visits, antibiotic prescribing did not change during this period (12% in 1995 to 11% in 2002; P = 0.08). During this time, fluoroquinolones increased to become the most commonly prescribed class of antibiotics among adults in the United States (Figure 1).
Fluoroquinolone prescribing
The sample
Discussion
In 2002, fluoroquinolones became the most commonly prescribed class of antibiotics among adults in the United States. From 1995 to 2002, fluoroquinolone prescribing among adults increased threefold, while there was no change in overall antibiotic prescribing. Roughly half of fluoroquinolone prescriptions were for conditions not approved by the FDA, and these unapproved prescriptions rose over time, increasing by 20% per year. The increase in fluoroquinolone prescribing was attributable to the
References (51)
- et al.
The problem of resistant bacteria for the management of acute otitis media
Pediatr Clin North Am
(1995) - et al.
The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitisa fifteen-year experience at the University of Virginia and review of other selected studies
J Allergy Clin Immunol
(1992) - et al.
Escherichia coli resistant to fluoroquinolones in patients with cancer and neutropenia
N Engl J Med
(1994) - et al.
A nosocomial outbreak of fluoroquinolone-resistant salmonella infection
N Engl J Med
(2001) - et al.
Risk factors for fluoroquinolone resistance in nosocomial Escherichia coli and Klebsiella pneumoniae infections
Arch Intern Med
(2002) - et al.
The emergence in Taiwan of fluoroquinolone resistance in Salmonella enterica serotype choleraesuis
N Engl J Med
(2002) Increases in fluoroquinolone-resistant Neisseria gonorrhoeae—Hawaii and California, 2001
MMWR Morb Mortal Wkly Rep
(2002)- et al.
Antibiotic resistance among gram-negative bacilli in US intensive care units
JAMA
(2003) - et al.
Longitudinal trends in fluoroquinolone resistance among Enterobacteriaceae isolates from inpatients and outpatients, 1989-2000: differences in the emergence and epidemiology of resistance across organisms
Clin Infect Dis
(2004) - et al.
Decreased susceptibility of Streptococcus pneumoniae to fluoroquinolones in CanadaCanadian Bacterial Surveillance Network
N Engl J Med
(1999)
Resistance of Streptococcus pneumoniae to fluoroquinolones—United States, 1995–1999
MMWR Morb Mortal Wkly Rep
Fluoroquinolone resistance in Streptococcus pneumoniae in United States since 1994-1995
Antimicrob Agents Chemother
Bacterial meningitis in the United States in 1995Active Surveillance Team
N Engl J Med
Increasing importance of antibiotic-resistant Streptococcus pneumoniae in acute otitis media
Pediatr Infect Dis J
Incidence of community-acquired pneumonia requiring hospitalizationResults of a population-based active surveillance study in Ohio
The Community-Based Pneumonia Incidence Study Group. Arch Intern Med
Bacteriology of maxillary sinusitis in relation to character of inflammation and prior treatment
Scand J Infect Dis
The rise of fluoroquinolone resistancefact or fiction
J Chemother
Resistance to levofloxacin and failure of treatment of pneumococcal pneumonia
N Engl J Med
Outpatient use of erythromycinlink to increased erythromycin resistance in group A streptococci
Clin Infect Dis
Erythromycin resistance of group A streptococci from throat samples is related to age
Pediatr Infect Dis J
Antimicrobial-drug use and changes in resistance in Streptococcus pneumoniae
Emerg Infect Dis
Streptococcus pyogenes resistance to erythromycin in relation to macrolide consumption in Spain (1986–1997)
J Antimicrob Chemother
Streptococcus pneumoniae resistance to erythromycin and penicillin in relation to macrolide and beta-lactam consumption in Spain (1979–1997)
J Antimicrob Chemother
Expanding uses of fluoroquinolonesopportunities and challenges
Ann Intern Med
National Ambulatory Medical Care Survey2001 Summary
Advance Data from Vital and Health Statistics
Cited by (265)
Convergent impact of vaccination and antibiotic pressures on pneumococcal populations
2024, Cell Chemical BiologyCorrelation between antibiotic consumption and resistance of Pseudomonas aeruginosa in a teaching hospital implementing an antimicrobial stewardship program: A longitudinal observational study
2023, Journal of Microbiology, Immunology and InfectionA Novel Process for the Key Intermediate of Fluoroquinolones
2023, Organic Preparations and Procedures InternationalUnraveling the sequence of electron flow along the cyclocondensation reaction between ciprofloxacin and thiosemicarbazide through the bonding evolution theory
2022, Journal of Molecular Graphics and ModellingComparative risk of serious hypoglycemia among persons dispensed a fluoroquinolone versus a non-fluoroquinolone antibiotic
2022, Diabetes Research and Clinical Practice
Dr. Linder is supported by a Career Development Award from the Agency for Healthcare Research and Quality (K08 HS014563). Dr. Huang is supported by a Career Development Award from the National Institute of Aging (K23 AG021963). Drs. Linder and Huang were supported in part by National Research Service Award 5T32PE11001-12. Dr. Steinman was supported by the VA National Quality Scholars Program and a VA Research Career Development award. Dr. Stafford was supported by the Donald W. Reynolds Center for Cardiovascular Disease at Stanford University and a research grant from the Agency for Healthcare Research and Quality (R01 HS11313).